Classification and Diagnosis of Schizophrenia
- Created by: Ashleigh Prince
- Created on: 02-03-15 18:28
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- Classification and Diagnosis of Schizophrenia
- Clinical Characteristics
- Profound disruption of cognition and emotion-affects language, perception, affect and sense of self
- Diagnosis of schizophrenia-under DSM-IVR, diagnosis requires at least a month's duration of two or more +ve symptoms
- +VE symptoms-excess or distortion of normal symptoms e.g. delusions, experiences of control, hallucinations etc.
- -VE symptoms- loss of normal functions, e.g. affective flattening, alogia, avolition
- Reliability
- Inter-rater reliability- DSM-III and later versions claim increased reliability and diagnosis.
- Test-retest reliability- screening tests such as RBANS show high test-retest reliability.
- Performance on measures of cogntive deficits linked with schizophrenia stable over a 6 month period
- Inter-rater reliability- despite claims for increased reliability, there is still little evidence the DSM is routinely used with high reliability by mental health clinicians
- 'On being sane in insane places'-demonstrated unreliability of diagnosis- Rosenhan
- Unreliable symptoms- diagnosis based on 'bizarre' delusions not a reliable method of distinguishing between schizophrenic and non-schizophrenic patients
- Comparing DSM and ICD- schizophrenia was more frequently diagnosed in ICD-10 than DSM-IV criteria (Cheniaux et al., 2009)
- Reliability of diagnosis challenged by differences between US and UK
- Validity
- Psychiatric comorbidities are common among patients with schizophrenia and creates difficulties in diagnosis of schizophrenia
- Comorbidity and medical complications- Weber found evidence of many comorbid non-psychiatric diagnoses among patients with schizophrenia, which affects prognosis
- Comorbidity and suicide risk- persons with schizophrenia at risk for suicide, with comorbid depression the major cause for suicidal behaviour
- Klosterkötter et al- found +ve symptoms more useful for diagnosis than -ve symptoms
- Prognosis-people diagnosed as schizophrenicrarely share the same symptoms, nor the same outcomes
- Ethnicity and misdiagnosis- rates of schizophrenia among African-Caribbeans much higher than white populations, which in part may be a product of misdiagnosis
- Symptoms- schizophrenia symptoms also found in many other disorders, including depression and DID
- Psychiatric comorbidities are common among patients with schizophrenia and creates difficulties in diagnosis of schizophrenia
- Clinical Characteristics
- Inter-rater reliability- despite claims for increased reliability, there is still little evidence the DSM is routinely used with high reliability by mental health clinicians
- 'On being sane in insane places'-demonstrated unreliability of diagnosis- Rosenhan
- Psychiatric comorbidities are common among patients with schizophrenia and creates difficulties in diagnosis of schizophrenia
- Comorbidity and medical complications- Weber found evidence of many comorbid non-psychiatric diagnoses among patients with schizophrenia, which affects prognosis
- Comorbidity and suicide risk- persons with schizophrenia at risk for suicide, with comorbid depression the major cause for suicidal behaviour
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